Interprofessional Identity Development: Awareness as the Beginning of Change

Abstract

Background: Developing an interprofessional identity (IPI) generates an intrinsic motivation for interprofessional collaboration owing to pro-diversity beliefs that mitigate identity threat within dynamic teams. However, personal experiences and contextual changes such as the transition into practice may decrease this openness and, as such, disrupt the complementarity between an individual’s professional and IPI. This study explores the construct of readiness-to-change as a missing link in strengthening IPI by revisiting the contested Readiness for Interprofessional Learning Scale (RIPLS). Methods: A pragmatic constructionist stance combining quantitative and qualitative approaches was adopted to determine the meaning and utility of a translated Dutch version of the RIPLS in an undergraduate university context. The validity and reliability were evaluated by analyzing cross-disciplinary data obtained from a cross-sectional (n=3311) and two prepost studies (n=330/n=89). In addition, a content analysis was performed by means of a coding frame and on the basis of interviews with teachers (n=2) and trainees (n=6) in health sciences. Results: Exploratory factor analysis, informed by the content analysis, led to a hypothesized one-factor model comprising 8 items with factor loadings between .512 and .697 and explaining 35.35% of the total variance (eigenvalue=3.463), which was relabeled the Awareness of Interprofessional Learning Scale (AIPLS). Confirmatory factor analysis with posttest data (n=456) showed excellent model fit (SRMR=.018, RMSEA=.068, CFI=.969, TLI=.957) and factor loadings (.62-.77), while both the unidimensional and 4-dimensional RIPLS’ structure showed very poor (SRMS=.071/RMSEA=.083) to reasonable (SRMS=.059/RMSEA=.067) model fit. Additionally, the AIPLS has a high coefficient omega (.81), moderate stability (ICC=.725) and confirmed convergent validity. Conclusions: The comprehensive approach adopted in this study led us to reject the RIPLS as a multidimensional instrument as the subscales showed considerable overlap and did not reflect the construct of readiness. Instead, the AIPLS measures interprofessional awareness, which is vital in the first stages in developing readiness, allowing us to reinterpret past research and to revisit the scale’s applicability in a theory-driven way. Moreover, we consider interprofessional awareness to be the beginning of change because it is a precursor of self-efficacy, openness and commitment, which may prove to be missing links to leverage in the delivery of interprofessional education.